Idiopathic and recurrent thromboembolic phenomena in cancer patients.
BACKGROUND
Venous thromboembolism (VTE) is one of the most common complications in cancer patients. It is not only associated with both reduced survival and a high number of recurrences, but an idiopathic VTE also increases the likelihood of a cancer diagnosis.


METHODS
Between January 2000 and October 2005 we reviewed the medical history of 88 patients who were admitted to a tertiary hospital and presented both a diagnosis of VTE and any type of tumour. The information collected included the type of tumour, the temporal association between tumour diagnosis and VTE, anticoagulation treatment applied and percentage of recurrences.


RESULTS
Ten patients (11.4%) presented the VTE prior to the cancer diagnosis; only half of them underwent a posterior tumour screening routine. Fifteen patients (17%) were diagnosed simultaneously and 71% presented the VTE after the tumour was detected. In 47 patients (53.4%) no risk factors for VTEs were detected. Twenty-nine patients (31.7%) presented a recurrent VTE, mainly during chemotherapy treatment (66%). Less than half of the patients (47.57%) were receiving treatment with low-molecular- weight heparins (LMWH).


CONCLUSIONS
Idiopathic VTEs may be the first manifestation of an occult neoplasia, but tumour screening is scheduled in only a few patients. Regarding the high incidence of recurrent VTE in cancer populations, a high percentage is attributed to the underuse of LMWH, whose efficacy in preventing recurrent phenomena is superior to oral dicumarinics.
López-Gómez
Miriam
M
Hospital Infanta Sofía, San Sebastián de los Reyes, Madrid, Spain. Miriam.lopez@telefonica.net
Gómez-Raposo
César
C
Sereno Moyano
María
M
Casado-Sáenz
Enrique
E
Feliú Batlle
Jaime
J
Ortega Ruipérez
Carolina
C
González Barón
Manuel
M
D000368:Aged; D000925:Anticoagulants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology* / Q000628:therapy; D012008:Recurrence; D054556:Venous Thromboembolism / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology*
D000925:Anticoagulants